This project focuses on three areas in the Evaluation and management of patient with critical illnesses or injuries. The first area involves the use of an objective Triage Index to quantitatively measure the impact of interventions by paramedics during the pre-hospital phase of care and compare the effects of these interventions with an EMT system. The second research area involves the development and validation of a set of patient outcome of decisions made by physicians. The composite project will allow accurate, objective characterization of the critically ill or injured patient from the time of entry into the EMS system, until the time at which final outcome is determined, thus providing a firm scientific basis for system, subsystem and clinical evaluation during the initial care of critically ill and injured patients. The third area of investigation involves the validation of a set of patient status indices to be used in formulating a global index predictor for patient outcome in patients suffering the effects of post-shock syndromes of any etiology.